Clichés of Progressivism, Part 14
Healthcare is important. People get sick and injured. As compassionate human beings, we should do what we can, within reason, to see that people are treated—especially when they don’t have the means to get treatment themselves. We can build and support charity hospitals. We can volunteer for free clinics. We can take sensible policy measures that will reduce the costs of and increase access to medical goods and services.
But we cannot pretend that healthcare is a right.
This sort of verbiage is just that—verbiage, until it requires enforcement. And if you have been tempted to think of basic needs as being rights, remember this: Rights confer duties upon others. And that has tremendous implications for any healthcare system.
Think about a right of free speech. That right confers a duty onto others not to interfere with or mute your expression, as long as you’re not harming or threatening anyone. But when it comes to certain other purported rights involving things that must be produced by others, like education or healthcare, that means others have a duty to produce that good or service. And once we slide from the apparently benevolent talk of people having rights to the reality that other people will then have enforced duties to produce those rights, we also slide from individual compassion to State compulsion. In other words, any such right necessarily conflicts with others’ rights not to be treated as means to some end.
In the process of outsourcing our sense of compassion to a central producer of healthcare goods and services, we cede our healthcare choices—and charitable instincts—to a central authority. How else is the government going to ensure that healthcare is produced, by right, for everyone?
This central authority, with its attendant healthcare bureaucracy, is not very good at figuring out who needs what and how much they need of it. Socialized, or “single payer,” healthcare systems that are meant to allocate healthcare goods and services have very different incentives than systems in which people exchange goods and services freely.
In the Soviet Union, planners had no price system to help them determine how many shoes were needed in Minsk or boots were needed in Moscow. Supply and demand were guesswork and “targets”—with all the attendant problems of political allocation, buck passing, and bread lines. The Soviet economy, marked by shortages and gluts, could not effectively be planned. The same can be said about the modern single payer healthcare system.
Consider our neighbors in Canada. In the Fraser Institute’s annual report, “Waiting Your Turn: Wait Times for Health Care in Canada,” the Canadian think tank says the median wait time in 2013 hit 18.2 weeks, three days longer than in 2012. The average wait time for orthopedic surgery, in particular, reached 39.6 weeks for treatment, while patients waited an average 17.4 weeks for an appointment with a neurosurgeon. During this time, people were suffering. Some even died. And yet all of this is happening in a country where healthcare is considered a right that confers duties on taxpayers. Can the suffering that flows from rationing be considered compassionate? If treating healthcare as a right has these sorts of perverse consequences, shouldn’t that lead us to question all such rights talk?
Put another way: Let’s grant for a moment that healthcare is a right, or, at least, let’s assume everyone wants healthcare to be something that our fellow citizens have access to. If we all agreed to that, what if we determined that a free market in medical care allowed more people to gain greater access to healthcare goods and services in a timely manner? Would a “right” to healthcare then confer duties upon policymakers to introduce measures like the following that would make the healthcare market freer?
- Let people choose less expensive health insurance policies and policy options that fit their circumstances and budgets—across state lines and free of some or all of the state mandates that price low-income people out of the marketplace.
- Encourage policies that restore a functioning price system to healthcare so that people can make wiser purchasing decisions, all of which will help rein in spiraling costs.
- Allow individuals, not just employers, to get a tax deduction when they buy health insurance, which would make insurance more personal and portable.
- Dismantle any and all healthcare schemes (like Medicare) that provide subsidies for the rich and tax the poor and middle class in the process.
- Remove barriers to competition such as professional licensing, certificates of need, and other regulations that hike costs and limit access.
- Encourage people to use financial healthcare products like health savings accounts, which give people incentives to be wise healthcare consumers, to save resources for future healthcare needs, and to invest in preventative measures?
Combined, the measures listed above would revolutionize the healthcare system in terms of price, quality, innovation, and access by the least advantaged.
Talk of “rights” is just a rhetorical game progressives play to get the policies they want (usually a single payer system). But talk of “rights” does nothing for the goal of actually figuring out how to get people reasonable access to the healthcare they need. To do that, we have to deal directly with the problems of affordability (as in the United States) or with the perverse consequences of rationing (as in Canada). The disastrous rollout of Obamacare just might stimulate a serious, widespread discussion of these options for the first time.
Yes, healthcare is something we’ll all need at one time or another. But it is not a right. If we really care about people getting healthcare, let’s focus on how to reform the system for good—so that free people can generate abundance in healthcare. If we can do it for mobile devices, we can do it for medicine.
- Claiming that one has a right to healthcare is rhetorical exercise. The rubber hits the road when it’s actually enforced, which means somebody has to be compelled to provide it or pay for it.
- Centralizing healthcare decisions is a movement in the wrong direction, away from the individual consumer and toward planners who have no special knowledge that would allow them to make good decisions for others.
- Market-based, consumer-focused options for healthcare deserve more serious consideration.
Used with the permission of the Foundation for Economic Education.